Clinical - Care Navigator

Below mentioned is the job description for your reference:

Position Title: Clinical - Care Navigator

Location: Remote, TX

Duration: 6 Months contract with possibility of extension and conversion

Working shift Monday-Friday 8am-5pm

Story Behind the Need:

• Health Plan
• Call Center
• Would be working with MSC Department and assisting in taking calls for our STAR+PLUS member.
• Team is to cover and answer calls that come in through call center.
• This is to cover the SCs who are out in LOA, FMLA and the openings we have open.
• Self-starters, eager to learn, great customer service
• Each day, they will interact with different members, learning from them and assisting with their individual needs

Typical Day in the Role:

• These positions work in a Call Center setting where the contractors are on a phone queue
• Day to Day responsibilities - Inbound call center, assist and educate Medicaid members on benefits and Services such as PCP Changes, ID Cards and Coordinate transportation and other services.

Education/Certification: HS Diploma

Years of experience required: Over 5 years of experience working directly with the ABD (Aged, Blind, and Disabled) population in call center environments, Medicaid programs, and Managed Care Organizations (MCOs). Skilled in supporting individuals with disabilities and vulnerable populations managing chronic or complex health conditions. Demonstrated expertise in providing care coordination for children, young adults, and other high-need groups within the past three of the last five years.

Must haves: good attendance, call center background; worked with MCO insurance

Nice to haves: background in Service Coordination, and call center experience.

Disqualifiers: no call center experience

Additional qualities to look for: Software Skills: Will be using various software on the job: Microsoft Office Suite, Avaya, Zoom, Skype

Preferred: BUT NOT Required: BA in Social Work or Healthcare Mgmt, LVN, CNA, CMA, RT, Pharmacy Tech

Top 3 must-have hard skills:

• Customer service, call center experience
• Computer Knowledge
• Insurance, MCO background.